Provider Demographics
NPI:1932631421
Name:EZE, OGONNA
Entity Type:Individual
Prefix:
First Name:OGONNA
Middle Name:
Last Name:EZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OGONNA
Other - Middle Name:
Other - Last Name:NWOSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7224
Mailing Address - Fax:
Practice Address - Street 1:1700 MEDICAL CENTER PKWY DEPT OF
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2245
Practice Address - Country:US
Practice Address - Phone:615-396-4694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN61903207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine